Introduction
When at the end of 35-36 weeks of pregnancy, the expectant mother often receives recommendations from the doctor to exclude heavy foods from her diet and limit flour, meat, and sweets. A couple of weeks before the expected date of birth, it is advised to eat mostly fruits, vegetables, stews, and boiled dishes, “lean” on fermented milk products. This is done to negate the risk of aspiration, which occurs when food or liquid is inhaled into the lungs, possibly leading to the death of a parturient woman. However, multiple studies argue that eating and drinking before and during labor do not affect the process. This paper will prove that the current policy of preventing oral intake during labor is completely unnecessary and should be abolished.
Literature Review
This paper utilizes three studies on the subject of oral intake before and during labor, as well as the restrictions imposed on it. The first academic paper questions the necessity of denying oral intake to women in labor (Palmer & Jiang, 2022). The study gives the reader an insight into the processes of gastric mobility in women in labor. The paper also goes through the root causes of the policy, giving the original studies that caused it and showing their lack of evidence.
The second study used in this paper is centered around inspecting the oral intake of fluids among women in labor and its effect on their gastric contents. Its goals were to determine whether or not oral fluid intake is associated with increased gastric contents which leads to aspiration (Rousset et al. 2020). To evaluate the findings, the study used ultrasound assessment of the gastric contents of parturient women.
The last academic paper that was used in this research was a literature review aimed at the lack of evidence that oral intake hurts a laboring woman’s health. The work stresses that the overall state of a woman in labor is poorly understood, especially their nutritional needs (Beggs, 2002). The study encourages the development of a new policy in this field, one that is appropriate for modern medical standards.
Proposed Change
The limitation of oral intake among women in labor should be abolished and instead, the choice of food and fluid intake should be given to them. There is no known effect of oral intake on the health of parturient women, and their nutritional needs are poorly understood. Thus, a more adequate choice would be to let the mother trust her instincts and leave the choice of eating or drinking to her (Beggs, 2002). The fears that surround the intake of food and drinks in this period are largely baseless, so there is no barrier to the introduction of a more liberal policy in this field (Palmer & Jiang, 2022). The intake of liquids has no impact on the antral cross-sectional area of parturient women, so it is safe to assume that they should be allowed to drink (Rousset et al. 2020). Thus, at least partial abolition of the restriction of oral intake during labor will not bring any risks, and the choice of eating and drinking should be left to the parturient women.
Justification of Proposed Change
As was mentioned above, several studies indicate that there is no difference in birth results between women who do and do not eat and drink during labor. The routine of restricting oral intake was first implemented in the middle of the twentieth century, after a study by Mendelson, who indicated 66 cases of aspiration out of 44,000 deliveries over 15 years of practice (Palmer & Jiang, 2022). However, this result is largely attributed to the practice of obstetric anesthesia which was used at the time (Palmer & Jiang, 2022). Thus, the cases of aspiration that led to the limitation of oral intake among parturient women were largely due to the undeveloped state of anesthesiology at the time.
Moreover, with the current state of medical care, the standard of anesthesia has changed dramatically. Currently, the advancements in the field of regional anesthesia have been able to reduce the number of incidents of gastric content inhalation (Rousset et al. 2020). A recent study shows that between the years 2013 and 2015, out of 240 maternal deaths, none were caused by aspiration (Rousset et al. 2020). Hence, the recent developments in anesthetics have largely removed the risk of aspiration during labor.
Lastly, the limitation itself was imposed and keeps being imposed due to the lack of knowledge on the subject. No credible research exists in modern medicine that states that eating or drinking in labor has any effect on the risk of aspiration (Beggs, 2002). Moreover, the restriction of oral intake is largely done because midwives are not involved in policy decisions and are not aware of the latest research, resorting to “common practice” (Beggs, 2002). Therefore, oral intake during labor does not affect the mortality rate of women, and the restriction on it is largely due to a lack of knowledge on the subject.
Conclusion
To summarize, oral intake during labor does not affect the outcomes of labor. The studies that led to this limitation are imprecise and outdated due to the state of anesthesiology at the time when they were made. The fears surrounding the restriction are largely baseless, so there is no reason for a more liberal policy to not be introduced. A more adequate solution would be to let the mothers decide whether or not to eat and drink during labor, and for the medical professionals to further their understanding of the nutritional needs of a woman in labor.
References
Beggs, J. A. (2002). Eat, Drink, and Be Labouring? The Journal of Perinatal Education, 11(1), 1-13. Web.
Palmer, C. M., Jiang, Y. (2022). Limiting Oral Intake during Labor: Do We Have It Right? Anesthesiology, 136, 528-530. Web.
Rousset, J., Clariot, S., Tounou, F., Burey, J., Hafiani M. E., Feliot, E., Quesnel, C., Bonnet, F. & Fischler, M. (2020). Oral fluid intake during the first stage of labor. European Journal of Anaesthesiology, 37(9), 810-817. Web.